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    Association of Low Serum Maresin-1 Levels with Hepatocellular Carcinoma in Cirrhotic Liver
    (Clin Lab Publ, 2024) Erguel, Bilal; Guel, Oezlem; Kisa, Uecler; Erdal, Harun; Tekin, Ercan; Oguz, Dilek
    Background: Maresin-1 (MaR1) is a macrophage-derived antiinflammatory lipid mediator that negatively regulates oxidative and proinflammatory cytokines and also restores integrity in various tissues after inflammation. Non-resolving inflammation is known to have an important role in the pathogenesis of hepatocellular carcinoma (HCC). The aim of the present study was to evaluate the role of MaR1 in pathogenesis and early diagnosis of HCC. Methods: The study was conducted in 102 participants, including 30 volunteers with no hepatic disease, 39 patients with hepatic cirrhosis, and 33 patients with HCC that developed additionally to cirrhosis. Serum MaR1 levels of all participants were measured by enzyme-linked immunosorbent assay (ELISA). Results: There was a significant difference between the circulating MaR1 levels of the three groups. MaR1 level was found to be significantly lower in the HCC group compared to the cirrhotic group (p < 0.001) and in the cirrhotic group compared to the healthy control group (p < 0.001). MaR1 level was independently associated with cirrhosis (vs. controls, OR: 0.995, p = 0.025) and with HCC (vs. controls, OR: 0.962, p = 0.035; and vs. cirrhotic patients, OR: 0.987, p = 0.006). ROC analyses demonstrated that MaR1 levels of < 311.66 had 72.73% sensitivity and 100% specificity for HCC differentiation from controls, while a < 428.08 cutoff had 96.97% sensitivity and 38.46% specificity for differentiation from cirrhotic patients. Conclusions: Serum MaR1 levels were significantly decreased in patients with HCC, compared to those with normal or cirrhotic hepatic tissue. Therefore, MaR1 may possibly be a valuable biomarker in the early diagnosis of HCC and in the differential diagnosis of HCC from cirrhosis.
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    Functional Bowel Disorder Management in Routine Practice with Tips for Hot Topics: Expert Opinion Review
    (Aves, 2024) Akyuz, Filiz; Celebi, Altay; Dogan, Ibrahim; Erzin, Yusuf; Kav, Taylan; Soyturk, Mujde; Oguz, Dilek
    Functional gastrointestinal system disorders are common problems in practice. The most common symptoms are abdominal pain, gas, bloating, diarrhea, constipation, and a mixture of these, and similar symptoms can be seen in conditions such as inflammatory bowel disease, colorectal cancer, and celiac disease depending on the age of the patient, indicating the importance of differential diagnosis. The importance of patient management is shown by making a symptom-based diagnosis and making cost-effective, that is, limited advanced examinations. The pathophysiology of irritable bowel syndrome (IBS) is multifactorial, and stress is one of the leading triggers of IBS symptoms. Therefore, terminology will change to gut-brain interaction disorders in the future, and the patient-physician relationship has a special place in the treatment of functional bowel disorder. Dietary recommendation and medical treatment in IBS should be determined according to the predominant symptom and symptom severity. In addition to diet, some lifestyle changes can also be helpful in reducing IBS symptoms. Antispasmodics and antidepressants are not fast-acting. These drugs should be used for at least 2-4 weeks to see the efficacy of treatment. Drugs should be used according to the standard recommended duration and dose in intermittent treatments.
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    Öğe
    Validity and Diagnostic Ability of Pancreatic Exocrine Insufficiency Questionnaire in Turkish Patients
    (Aves, 2024) Oguz, Dilek; Kalkan, Ismail Hakki; Soyturk, Mujde; Demir, Kadir; Oruc, Nevin; Bengi, Goksel; Gul, Ozlem
    Background/Aims: Pancreatic exocrine insufficiency (PEI) is a prevalent disease that is often underdiagnosed and undertreated, leading to resulting in diminished health-related quality of life. The PEI questionnaire (PEI-Q), a patient-reported outcome questionnaire developed to diagnose and evaluate PEI, is available only in English. The study aimed to provide a Turkish translation of PEI-Q and validate its reliability and diagnostic performance in a Turkish-speaking population with PEI. Materials and Methods: This study included 161 participants: 98 patients with PEI and 63 healthy controls. Participants underwent the PEI-Q test, and the results were statistically analyzed for reliability and validity. The diagnostic value of PEI-Q was determined using receiver operating characteristic (ROC) curves. Cronbach's alpha was used to assess internal consistency, while exploratory factor analysis was performed to determine construct validity and reveal the factor structure. Results: The mean age of participants was 45.0 years, and 60.2% were male. Participants with PEI were significantly older than those without. Scores for abdominal, bowel movement, and total symptoms were significantly higher in patients with PEI than in controls. ROC analysis revealed good diagnostic value for PEI-Q, with areas under the curve ranging from 0.798 to 0.851 for different symptom scores. Cronbach's alpha coefficients were above 0.70, indicating good internal consistency, and exploratory factor analysis supported a 4-factor structure, accounting for 68.9% of the total variance. Conclusion: The Turkish version of the PEI-Q is a reliable, easy-to-use, and valid screening tool for diagnosing PEI. It consistently assesses symptoms and quality of life in patients with PEI, helping to inform diagnosis and treatment.